Reversing what had been an encouraging two-year trend, reports of drug abuse requiring emergency room care in the Baltimore area rose by 12.5 percent between 2001 and last year while they remained constant nationally.
The Baltimore region also has the second-worst drug-abuse hospitalization rate in the nation, behind the Philadelphia area, according to reports released yesterday by the U.S. Department of Health and Human Services.
Despite the recent increase, there are signs of an encouraging longer-term trend, said Judy Ball, project director for the federal Drug Abuse Warning Network.
"This may be a blip," Ball said. "The long-term trend is generally downward for the Baltimore area. The numbers in 2002 are still lower than they were in 1995."
The number of reports of abuse of prescription painkillers, such as OxyContin, rose by 47 percent in the Baltimore area, from 2,624 in 2001 to 3,848 last year. This is part of a national rise in the abuse of these drugs, Ball said.
"This is something we're trying to keep an eye on," she said. "Some people think that abusing prescription drugs is safer than abusing illegal drugs, but that's not necessarily true."
The rise in OxyContin abuse appears to be more a suburban and rural phenomenon than an urban one, said Baltimore Health Commissioner Dr. Peter L. Beilenson, with no deaths reported in the city from the legal narcotic.
Reports of cocaine abuse requiring emergency room care rose by 21 percent in the Baltimore region from 2001 to last year, while they rose 5 percent for heroin abuse, according to the federal statistics. PCP abuse was up 60 percent.
In Baltimore, Mayor Martin O'Malley for months has used the 25 percent drop from 1999 to 2001 as evidence of the success of his two-pronged approach to fighting addiction: more treatment and more arrests.
In contrast to his predecessor, Mayor Kurt L. Schmoke, who de-emphasized arrests for drug enforcement, O'Malley's Police Department drove up the number of drug arrests by 66 percent from 1999 to 2001 while the number of people being treated for addiction increased by 60 percent from 1999 to this year.
Yesterday, the mayor said he was still encouraged by the overall downward trend over three years. The city had the second highest rate of decline from 1999 to last year after Dallas, O'Malley said.
"We are trying to take a long-term view, and we hope that the numbers next year will continue the downward trend," the mayor said. "I don't think the figures from this one year mean we are going backward. ... There are a lot of other mayors on this list who would like to have our three-year numbers."
Beilenson said the trend is worse in some other cities: The number of drug-abuse episodes reported by hospitals rose 54 percent in the Boston area between 1999 and last year, 52 percent in St. Louis, 42 percent in Buffalo, N.Y., and 39 percent in Atlanta.
Beilenson said he had no theories for why drug-related emergency room visits in the Baltimore area would have increased between 2001 and last year while the number of people being treated for addiction rose from 19,558 to 22,274.
"It was pretty easy to explain the downward trend, because we had so much more drug treatment," Beilenson said. "But I don't know how to explain this. Is the stuff out there that much more potent?"
The statistics released yesterday represent the number of times the top 15 major abused drugs were mentioned on reports as contributing to the cause of an emergency room visit at 20 hospitals in the city, and in Anne Arundel, Baltimore, Carroll, Harford, Howard and Queen Anne's counties.
The region's hospitalization rate for drug abuse was 555 emergency room visits per 100,000 population, second only to Philadelphia, which had a rate of 612.
In Carroll County, heroin-related emergency department admissions for adults are the highest they have been in five years, said Mark Yount, the county's substance abuse prevention coordinator. The county recorded 55 heroin-related admissions last month vs. 25 for all of last year and seven in 1999.
Carroll County General Hospital and a nonprofit drug treatment center in Westminster called Junction also have seen more people mixing cocaine and heroin -- speedballing, or Belushi balls, named after actor John Belushi, who died from the lethal combination.
In Anne Arundel County, Lt. Randall R. Jones, commander of the vice-narcotics unit, said authorities have seen a large increase in the number of Percocet and OxyContin cases they handle.
"Our biggest pattern shift has been that of OxyContin," Jones said.
At the Anne Arundel Medical Center, emergency room doctors say they are not seeing an increase in the number of drug-related visits to the emergency room. But they have seen an increase in PCP use and an increase in prescription altering, said Dr. David Mooradian, an emergency room physician.
Mooradian said some patients will try to change a prescription for six pills to one for, say, 60 pills, hoping that the pharmacist won't check with the doctor. Prescriptions for painkillers such as Vicodin, Lortab and Percocet are among the most popular ones forged.
In Howard County, alcohol and marijuana use remains the biggest problem.
But Tom Cargiulo, the county's substance abuse services director, said he has a "gut feeling" that the county will soon see increases in PCP and heroin use, along with an expected drop in use of Ecstasy and ketamine, an anesthetic often used for animals.
Sun staff writers Julie Bykowicz, Lisa Goldberg, Alyson R. Klein, Rona Kobell and Athima Chansanchai contributed to this article.